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2012 Texas Medicaid Provider Procedures Manual

Volume 1, General Information : Section 6: Claims Filing : 6.7 2006 American Dental Association (ADA) Dental Claim Filing Instructions : 6.7.3 2006 ADA Dental Claim Form

6.7.3
Samples of the ADA Dental Claim form can be found on the ADA website at www.ada.org/3017.aspx?currentTab=2.

Texas Medicaid & Healthcare Partnership
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